Project Summary/ Abstract Sjgren?s syndrome (SS) is an incurable systemic disease, characterized by chronic autoimmmune-induced inflammation of the lacrimal and salivary glands and substantial morbidity, including dryness of the eyes and mouth, internal organ involvement, and a heightened risk for lymphoma. No disease-modifying drugs are available for SS. Clinical trials of various therapeutic agents, including biologics, have failed, likely from disease heterogeneity, insensitive outcome measures, and inappropriate therapeutic target selection. There is thus a huge unmet need for better treatments of this disease. The International Symposium on Sjogren?s Syndrome (ISSS) is the only international meeting specifically dedicated to SS. It is held every 2-3 years and brings together oral medicine specialists, rheumatologists, ophthalmologists, drug developers, and basic researchers to present their latest SS research findings and insights. The next ISSS will be held in Washington DC, on April 18-21, 2018 and will be chaired by Ilias Alevizos, DMD, Ph.D, Alan Baer, MD and Esen Aspek, MD, representing the three main medical disciplines involved in the diagnosis and treatment of SS, namely oral medicine, rheumatology and ophthalmology. The primary objective of the 14th ISSS will be to foster successful drug development and clinical trial design for SS. The title of the symposium will thus be ?Sjgren's Syndrome: Paths to Precision Diagnosis and Therapy?. The symposium will focus on disease subsetting through the use of biomarkers, genetic tests and molecular studies of target tissue, clinical trial design and outcome measures, standardization of salivary gland histopathologic scoring, and identification of pathophysiologic pathways amenable to therapeutic targeting. The secondary objectives of the 14th ISSS include: 1. To develop consensus on a protocol for the histopathologic interpretation of labial and parotid gland biopsies, to be used for SS diagnosis and as an outcome measure for clinical trials. 2. To develop consensus on a standardized format for cohort database entries. With the advent of high-throughput sequencing data, there is a large need to standardize protocols on how to obtain and organize the appropriate clinical information and link it to genetic data. 3. To bring together young investigators, clinical fellows and postdoctoral associates in this international, focused conference and provide them with the chance to present their work, exchange ideas and network with more senior investigators in the field.